CMS announces innovative payment model for radiation oncology

PARCA eNews – Sept. 18, 2020 – The Centers for Medicare and Medicaid Services (CMS) unveiled a new payment model for cancer patients receiving radiotherapy that allows providers to focus on delivering high-quality treatments.

The new Radiation Oncology model allows for value-based focus by creating a simpler, more predictable payments that incentivize cost-efficient and clinically effective treatments to improve quality and outcomes. Current payment is based on the number of treatments and where patients receive it such as in a hospital outpatient department or a freestanding radiation therapy center, which can lead to more time traveling for treatment with little clinical value, according to CMS Administrator Seema Verma.
With the potential of fewer treatments and better outcomes, the radiation oncology model can help patients reduce travel time required for treatment, reduce side effects, lessen the time spent in a doctor’s office or waiting room, and free up time for patients to engage in other activities that can help improve their overall quality of life.

The rule is part of the final rules on specialty care models issued by CMS and is scheduled to go into effect Jan. 1, 2021. The CMS estimates the new payment model will save Medicare $230 million over five years.

For a fact sheet on the RO Model, please visit: Radiation Model Fact Sheet and at the Radiation Oncology Model information page.

Source: CMS press release